Risks

'Slamming' drugs is a riskier way to take drugs than other methods. Below is some advice on safer ways to inject.

Important:

Never inject below your waist

Avoid injecting into your hands or feet

Never inject deeper than 5mm or you may hit an artery or a nerve. Arteries are deeper and harder to pierce than veins, the blood is brighter and it will spurt rather than ooze

Never inject into a site that is sore, swollen or tender

Don’t inject into the same spot two times in a row. Vary your injecting sites to give the vein a break and to recover

Don’t bend your elbow to stop the bleeding – apply pressure and hold the bleeding site

Safer injecting practices

If you are injecting it is safer to do it yourself if you can, you then have power over of the situation. You can practice safer injecting practices like being hygiene aware and can stop if you feel something is wrong.

Never use alone. Having someone else there is important if your body reacts in a way you did not expect

Wash your hands with warm soapy water before and after injecting

Never let a used fit come into contact with a group mix. No matter how well it has been cleaned everyone must have their own fit, water, spoon and filter

Stock up on equipment so you don’t run out, always get more than you think you will need

Always mix up on a clean space (wipe with a clean cloth and soapy water or use new swabs)

Clean your spoon before mixing up (wipe once with a new swab)

If you can’t wash your hands use single wipes with new swabs. Remember – rubbing swabs backwards and forwards spreads the dirt and bacteria around

Stop the flow of blood after injecting with clean cotton wool, tissues or clean toilet paper

Have your own tourniquet and don’t share it, wash it regularly to remove blood

Rinse your fit with clean, cold tap water straight after your hit to help remove traces of blood

If you keep your own fit, mark it and keep it somewhere safe

Always dispose of injecting equipment in a disposal container or a puncture-proof container with a child-proof lid. If possible return the container to your local needle and syringe exchange programme

Don’t re-use swabs, filters or open water ampoules as they can become contaminated once opened. Dispose of them with your fits or inside two plastic bags

Be aware of blood on sleeves and clothes – if you get blood on your clothes, tourniquet or other washable items wash them immediately

If someone is helping you inject, make sure they wash their hands before and after

Injecting over a long period of time can result in:

Blocked blood vessels (caused by things mixed or cut with the drugs)

Inflamed blood vessels and abscesses

Damage to vital organs such as the liver, heart or lungs

Injecting may also increase the risk of becoming dependent on the drug thereby exposing you to serious mental health problems

Crystal meth is a strong, highly addictive amphetamine stimulant which is usually snorted, smoked, mixed with water and injected (slamming), or injected inside the anus (booty bumping). It releases the brain’s stress hormone norepinephrine and ‘feel good’ chemicals dopamine and serotonin which makes people feel high, full of energy, confident, invincible, impulsive, less likely to feel pain and very horny with fewer inhibitions. It also increases the appetite and energy levels, so people taking Crystal can go for days without eating or sleeping. It is often used during non-stop sex sessions and on the clubbing scene.

Sex on Crystal MethCrystal can make people feel extremely sexually aroused for long periods. People using this drug may do things they wouldn’t normally do, including risking picking up or passing on HIV. It often makes it difficult for men to get an erection or ejaculate (known as ‘crystal dick’). It can become hard to think of having sex without being on meth and – like G and mephedrone – it can have a big impact on your ability to have sex sober.

Health risks of Crystal Meth

Long or rougher crystal-fuelled sex sessions can cause the genitals, mouth or anus to become irritated, sore or bleed. This may not be noticed at the time, but it can increase the risk of HIV, Hepatitis C and other sexually transmitted infections being passed on.

Due to increasing the body temperature, heart beat and blood pressure, it can increase the risk of heart attack, stroke, coma or death

Comedowns can leave a person exhausted, aggressive and paranoid, in some cases even suicidal.

People can develop stomach problems such as acid reflux or gastritis due to not eating for a long period of time.

With long-term use, crystal meth can damage the lungs, nose and mouth and lead to lasting mental health problems, even after quitting the drug. It can also interact dangerously with other recreational and prescription drugs

People may find quitting crystal very difficult and its effects on the brain can last long after giving the drug up.

Useful to know

Injecting is best avoided. It’s the quickest way to getting addicted and runs the risk of serious health problems (skin abscesses, collapsed veins, blood poisoning and heart infections).

Sharing injecting equipment puts you at high risk of getting or passing on HIV, Hepatitis C and other infections.

Using hot pipes might injure your mouth and if you share them it risks passing on infections like hepatitis C and HIV.

Condoms are more likely to break after about half an hour of use. So during long sex sessions it makes sense to check condoms regularly and put a fresh one on after 30 minutes.

Although Mephedrone (Meph) is now illegal, it developed popularity in 2009 along with other so called “Legal Highs”. It is a stimulant that causes speediness and euphoric effects.

Psychological dependance is common with Mephedrone. If you’re worried this applies to you come and see us.

Mephedrone is most often a powder and can be snorted, mixed with a drink, “bombed” (wrapped in paper or put in a capsule and swallowed), booty-bumped (syringed up the anus) or injected.

Meph is very irritant and commonly causes inflammation.

Snorting the drugs can cause nose bleeds. Swallowing it mixed with a drink can cause a sore throat.. It is particularly damaging to your veins. The best harm reduction advice (besides not doing it at all) would be to “bomb” it in a paper wrap or capsule, to avoid the aggravation to nostrils, veins and throat.

Side effects include heart palpitations, anxiety, sleeplessness, temperature fluctuations and in some cases hallucinations and fainting.

GHB/GBL causes a feeling of euphoria and reduced inhibitions, but when used carelessly it can also be very dangerous.

There are many common dangers with GHB/GBL including accidental overdose, “going under” on a dance-floor, date-rapes in saunas, or visits to A&E. People using the drug frequently can physically dependent (addicted) to the drug. They may find themselves forced to dose hourly to avoid difficult and dangerous withdrawal symptoms.

Dependent use means that stopping GHB/GBL without medical supervision poses dangerous health risks, to clear your system you will require an in-patient detox.

Recreational Use

Always be responsible for your own dosing. Always.

Avoid mixing GHB/GBL with alcohol and ketamine as this increases your chance of ‘going under’ or having fits and coma

Take appropriate doses at appropriate time intervals. A commonly used dose would be between 0.5ml and 1ml. Never dose again within the same 3 hour period

Stick to your own doses and times. Don’t accept GHB/GBL from friends just because it’s being offered

Use a measured dropper bottle or syringe to measure your doses. Never just pour it casually into a cup and never drink from the bottle or from someone else’s drink

Dependence

If you use GHB/GBL regularly for a long weekend you might find yourself feeling anxious, sweaty and shaky the week after or unable to sleep. These are the first signs of dependence (addiction). Even though a shot of GHB/GBL would alleviate these symptoms, resist the urge to take GHB/GBL and try to ride out these early signs with rest and stress free activities.

If you have become dependent on GHB/GBL, your withdrawals will be shakes, sweats, sleeplessness and extreme anxiety. In this case, you should continue taking your GHB/GBL in regular amounts at regular time intervals. Then you can seek medical advice from a drugs advisor at 56 Dean Street, Antidote, your local borough drug service, or GP

Keep a record of your doses and times, to stabilise your use and reduce chaotic ups and downs.

If you’re experiencing withdrawals and have no GHB/GBL you should go to A&E and be honest about your situation. This is the safest course of action as withdrawals can be dangerous.

Try not to panic, help is available

NOTE:

GHB and GBL are not the same thing; GHB is the chemical produced in the body when we drink GBL. (The liver converts the GBL to GHB after ingestion.) And sometimes, though less commonly, GHB is a different form of the drug that can come as a powder or liquid, different from GBL. In regard to the effects on the body, they are essentially the same; but when it comes to dosing, it is important to understand the difference.

GBL is the most commonly used form of the drug, and the one you are most likely to find available on the internet, often sold as a liquid cleaning solvent. Concentrations of GBL when bought on the internet rarely vary enough to cause concern in regard to dosing. Take appropriate doses at appropriate time intervals. A commonly used dose of GBL might be between 0.5ml and 1ml. Never dose again within the same 3 hour period. If unsure or inexperienced, always start with the lowest dose, and if it doesn’t work after 45 minutes, you might increment up; in this case, make sure your second dose is never more than half of your first dose.

GHB is less commonly available than GBL; sometimes sold as a powder to be mixed with water (never sniffed, never injected), and sometimes already mixed and in liquid form (liquid GHB). This would be more likely to have been sold to you by a dealer or on the dark web, than via traditional internet shopping. GHB in liquid form (not GBL) is perhaps the most dangerous way to ingest the drug, as the concentration can vary enormously. Some samples of liquid GHB in Holland measured between 350 and 550 mg/ml; but without testing your sample, there is really no way of knowing the concentration of your liquid GHB, so be extremely careful. Don’t assume anything. Carefully check the concentration with your source before calculating your dosage. 2.5ml of liquid GHB might be a safe dose to start with – but again, there are no guarantees, and be sure that it is GHB and not GBL you are using, as a 2.5ml dose of GBL could be fatal.

Always start with a low dose to determine if it works for you, and if there is no effect after 45 minutes, increment up gently with a second dose; this second dose should never be more than half of your first dose.

Whether it is GHB or GBL you are using, appropriate dosing vary person to person, depending on body weight, how much sleep you’ve had, when you ate last, other drugs you might have taken, and other factors. Alcohol and Ketamine are especially dangerous in this regard, and should never be used with GHB/GBL.

Both GHB and GBL are drugs that can develop into a physical dependence, and if this kind of addiction develops, you should not consider stopping “cold turkey” without advice from a doctor or drugs worker, as these withdrawal symptoms can be dangerous, and sometimes fatal. Sexual assaults, poor choices around safer sex, and overdsoses (sometimes fatal) are commonly reported consequences of GHB and GBL.

If a new pair of gloves is used with each sexual partner you can cut the risk of most infections, you can pick up gloves as well as lube and condoms from 56 Dean Street.

There is a risk of HIV transmission from fisting if the fister (the guy doing the fisting) has cuts or sores on his hand or wrist

It is easy to damage the lining of the rectum when fisting, so if fisting is followed by condomless anal sex the risk of transmission of HIV and Hepatitis C to either partner is much higher.

Using oil-based lube (such as Crisco) for fisting can cause problems if you have anal sex afterwards. This is because the oil damages the rubber that’s used in most condoms. Either use a water-based lubricant or switch to non-latex condoms which are not affected.

If more than one person is being fisted, HIV or Hepatitis C could be passed from one fistee to another via anal mucus or blood carried on the fist

It’s best to have your own pot of lube. Sharing lube can also lead to the transmission of HIV and other STIs, as the pot can become contaminated with others blood or anal mucus

Hepatitis A and gut infections like salmonella and shigella (causing fever, diarrhoea with blood and mucus) can get passed on if anything gets passed to the mouth

Shared dildos and butt plugs can pass on infections. Wash sex toys thoroughly after use, using warm soapy water or a sterilising fluid designed for baby bottles.

Alternatively use a condom on it and change it between partners.

Using sex toys may cause microscopic damage inside. You may not notice anything but it may increase the chance of HIV transmission if followed by condomless sex.

Shared penile toys such as Fleshlights can also pass on infections. As with dildos, you should wash them thoroughly after use, using warm soapy water or a sterilising fluid designed for baby bottles.

Using other household objects can be very dangerous. If you do, avoid anything with sharp edges or anything that may break inside you. If it doesn’t have a base, be careful not to let it go too deep inside you. If you lose anything inside go to A&E.

How do I play safely?

Play with someone you trust if possible, as your judgment can be dramatically impaired on chems

Establish a set of boundaries while sober about what you are not prepared to do sexually and with chems, that you can refer to later when high

Don’t play for too long – paranoia and hallucinations can be common on your second day awake

Do not share needles, or other injecting equipment. Clean needles can be obtained from Dean Street at any of the walk-in times. If you aren’t aware of all safer injecting practices please speak to a drugs advisor in-clinic chemsex puts you at higher risk of infections. If you’re HIV negative, and concerned about any HIV risks during a chemsex episode, speak to us about PEP, a medicine which can help protect you from becoming infected if taken within 72 hours of the possible exposure

If you’re looking to spend your evenings/weekends/spare time differently, have a browse through our list of alternative sporting, social and recreational activities, specifically for gay men

Don’t play too regularly if you want to avoid depression, weight loss and psychological dependence. Pepper your sex life with some sober sex, some dating and plenty of non-sexual recreation and intimacy

There are currently safer slamming packs available to buy online from many retailers, or available from NHS or charity services depending on your location. These packs will often include multiple clean needles which are colour coded to prevent accidental needle sharing, as well as condoms, sterilisation equipment and a sharps container.